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Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy: experience from a large prospective series
Open accessAbstract
Background: Helicobacter pylori plays a decisive role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT), and eradication therapy has become a widely accepted initial treatment of stage I disease. Objective: To determine the long term outcome of patients undergoing exclusive H pylori eradication therapy. Design: A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT. Setting: Multicentre study in Germany and Austria. Patients: Ninety five patients; 90 of these (five lost to follow up) with a mean age of 54.3 (27–85) years were followed up for at least 12 months. Intervention: Complete staging work up revealing stage I disease and H pylori infection. Patients received triple therapy (OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week. Results: Median follow up was 44.6 (12–89) months. H pylori was successfully eradicated in 88 patients (98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients (62%), minimal residual disease in 17 patients (18%), partial remission in 11 patients (12%), no change in four patients (4%), and progressive disease in two patients (2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by H pylori . Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound. Conclusion: The majority of patients with low grade gastric MALT lymphoma treated by exclusive H pylori eradication have a favourable long term outcome, offering a real chance of cure.
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Cited by
Pathogenesis of Helicobacter pylori Infection
Kusters, J. G., van Vliet, A. H. M., & Kuipers, E. J. (2006) · Clinical Microbiology Reviews · doi:10.1128/cmr.00054-05 · Cited by 2,526
McColl, K. E. L. (2010) · New England Journal of Medicine · doi:10.1056/nejmcp1001110 · Cited by 773
THE PATHOGENESIS OF HELICOBACTER PYLORI–INDUCED GASTRO-DUODENAL DISEASES
Atherton, J. C. (2006) · Annual Review of Pathology: Mechanisms of Disease · doi:10.1146/annurev.pathol.1.110304.100125 · Cited by 567
MALT lymphoma: from morphology to molecules
Isaacson, P. G., & Du, M.-Q. (2004) · Nature Reviews Cancer · doi:10.1038/nrc1409 · Cited by 522
Long-Term Follow-Up of Gastric MALT Lymphoma After Helicobacter Pylori Eradication
Wündisch, T., Thiede, C., Morgner, A., Dempfle, A., Günther, A., Liu, H., Ye, H., Du, M.-Q., Kim, T. D., Bayerdörffer, E., et al. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.02.3903 · Cited by 317
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Metadata
- Authors
- Fischbach, W., Goebeler-Kolve, M.-E., Dragosics, B., Greiner, A., & Stolte, M.
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2003-12-18
- Volume
- 53
- Issue
- 1
- Pages
- 34-37
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W1988021144
- Cited by
- 354
- References
- 0
- FWCI
- 22.25
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Fischbach, W., Goebeler-Kolve, M.-E., Dragosics, B., Greiner, A., & Stolte, M. (2004). Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy: experience from a large prospective series. Gut. https://doi.org/10.1136/gut.53.1.34
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